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What’s The Deal With Growth Charts?

Babies come in all colors, shapes and sizes due to many factors including genes, activity level and even gender. So it can be quite difficult for a pediatrician to judge a child’s growth as normal just by looking at it. To truly assess a child’s growth and development, pediatricians use growth charts, such as a child’s height percentile.

What are Growth Charts? WHO growth charts are tools that doctors use to track a child’s growth and development over time. These charts are based on research conducted by the World Health Organization on thousands of children around the world living in optimal environments. Data on their growth rates for height, weight and head circumference was collected over time and plotted on a chart that shows how the children should grow if they have optimal conditions. When using WHO growth charts, such as a child’s height percentile, doctors are able to do two things. First, they are able to compare the child’s height, weight and head circumference with other children of the same gender and age. Second, and more importantly, they are able to monitor the child’s growth rate and see if it is following a regular pattern.

Parents often focus more on one point on the chart, especially where their child is at the moment. Additionally, many believe that a higher percentile means a healthier baby. However, when it comes to these types of growth charts, the “score” is not what makes a child healthy and normal. Instead, the score is simply a means of determining what the child’s growth pattern is.

So how does it work? Using a child’s height percentile, for example, would require a doctor to plot the child’s height as it grows over time. Looking at just one entry in the table will tell him nothing about the child’s health. This is because several factors affect a child’s height, not just what he eats and drinks. A baby whose parents are only 5’2″ can’t be expected to be in the 90th percentile on the baby’s height percentile chart. After all, that chart is based on the average height of the baby’s peers. Plus, there will be more babies his age who are taller than him, just as there are probably a larger number of adults taller than his parents. So a doctor may not necessarily be concerned if a baby has a low “score” on the child’s height percentile or any growth chart. Instead, he will be interested in a few points on the chart that plot the child’s height over several months. These points should be, more or less, all in the same percentile—stable as the child grows. If the child was in the 40th percentile during January through May, then suddenly dropped to the 10th percentile in June, and in July it went even lower, it may mean that something is wrong and the doctor will have to do another examination.

Another important interpretation of the results that doctors make is comparing the child’s growth measurements against each other. The height and weight of the child should be proportional. A child who reaches the 90th percentile for weight and 10th percentile for height probably weighs more than he should. Likewise, a child who draws high on the height chart and low on the weight chart may weigh less than he should.

When it comes to growth charts like a child’s height percentile, parents should always remember that how their child “scores” is less important than what their growth trend is. Taller is not always better. And growth trends don’t happen overnight.

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